Journal
CLINICAL LYMPHOMA & MYELOMA
Volume 9, Issue 2, Pages 151-153Publisher
CIG MEDIA GROUP, LP
DOI: 10.3816/CLM.2009.n.036
Keywords
Dermatomal rash; Herpes zoster; Herpetic neuralgia; Infectious complications
Categories
Funding
- [MSMT LC 06027]
- [MSM 0021622434]
- [16A MZCO]
- [NR/9225]
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Background: Varicella-zoster virus (VZV) reactivation is a common complication in patients with multiple myeloma (MM) treated with bortezomib, with an incidence rate of 10%-60%. The aim of our study was to analyze the effect of acyclovir prophylaxis in this patient population. Patients and Methods: We studied 98 consecutive patients with relapsed MM treated with bortezomib. Bortezomib 1.3 mg/m(2) was given on days 1, 4, 8, and 11 of a 21-day cycle. At first, patients did not receive any VZV prophylaxis, but because of the high incidence of VZV reactivation, VZV prophylaxis with acyclovir was implemented subsequently. Results: A total of 11 patients treated with bortezomib did not have any VZV prophylaxis, and 4 of these 11 patients (36%) developed VZV reactivation in the form of herpes zoster. No VZV reactivations were observed in the 32 patients who received acyclovir 400 mg 3 times daily or the 55 patients who received acyclovir in a dose reduced to 400 mg once daily during bortezomib treatment. Conclusion: Varicella-zoster virus reactivation is a common and serious adverse effect of bortezomib treatment. Acyclovir 400 mg once daily is sufficient to protect from VZV reactivation in patients with MM treated with bortezomib.
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